Individual
MR. SHAD JEFFRY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1080 N CAMPBELL RD, APT 4, ROYAL OAK, MI 48067-1533
(941) 527-7301
(313) 577-1012
Mailing address
1080 N CAMPBELL RD, APT. 4, ROYAL OAK, MI 48067-1533
(941) 527-7301
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/19/2005
Last updated
07/20/2008
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